Promising faster-acting insulin aspart results
Adults with type 1 diabetes treated with faster-acting insulin aspart had significantly reduced HbA1c and improved postprandial glucose (PPG) control after two-hours when compared with NovoRapid® (insulin aspart) in a basal-bolus regimen, it has been announced.
Full results from onset 1 and onset 2 — the phase 3a trials assessing the use of faster-acting insulin aspart in people with type 1 diabetes (onset 1) and type 2 diabetes (onset 2) — were presented at the 76th annual Scientific Sessions of the American Diabetes Association (ADA) in New Orleans, USA.
In onset 1, after 26 weeks of randomised therapy, faster-acting insulin apart showed:
- Significant HbA1c reduction versus insulin aspart in adults with type 1 diabetes when dosed at mealtime (95 per cent confidence interval [CI] -0.15 [-0.23; -0.07]
- Comparable HbA1c reduction when dosed 20 minutes after starting a meal compared with insulin aspart dosed at mealtime (95 per cent CI 0.04 [-0.04; 0.12])
- Superior reduction in the rise of two-hour PPG (95 per cent CI -0.67 [-1.29; -0.04] mmol/L) versus insulin aspart
- A reduction in the one-hour PPG increment* (95 per cent CI -1.18 [-1.65; -0.71] mmol/L), a secondary supportive endpoint
In onset 2, faster-acting insulin aspart showed:
- Comparable reduction versus insulin aspart in reducing HbA1c in adults with type 2 diabetes (95 per cent CI -0.02 [-0.15; 0.10])
- A reduction in the one-hour PPG increment* (95 per cent CI -0.59 [-1.09; -0.09] mmol/L), a secondary supportive endpoint
- No significant reduction in the rise of two-hour PPG (95 per cent CI -0.36 [-0.81; 0.08] mmol/L)
Professor David Russell-Jones, a Consultant Physician at the Royal Surrey County Hospital, and Professor of Diabetes and Endocrinology at the University of Surrey, was the primary investigator for onset 1.
Improving PPG control is important in achieving HbA1c targets
He said: “Improving PPG control is important in achieving HbA1c targets for patients with type 1 or type 2 diabetes. Poor control of PPG can often result in post-meal hyperglycaemia, which can have a wide-range of negative effects on patients.”
“The results from onset 1 and onset 2 showed that faster-acting insulin aspart improved PPG control compared with insulin aspart; HbA1c outcomes were also significantly improved in type 1 patients and non-inferior in type 2 patients.
“Of particular interest was the finding that post-meal dosing of faster-acting insulin aspart was as effective as pre- meal dosing of insulin aspart in patients with type 1 diabetes, which highlights the potential physiological and lifestyle advantages of this faster insulin formulation.”
In both trials, the previously reported safety and tolerability profiles of faster-acting insulin aspart and insulin aspart were confirmed. No apparent differences were identified between the two treatment groups with respect to adverse events and other safety parameters.
The most commonly reported adverse event associated with faster-acting insulin aspart in the onset 1 and onset 2 studies was hypoglycaemia. No significant difference in the overall rate of severe or confirmed hypoglycaemia in people with type 1 or type 2 diabetes was identified between faster-acting insulin aspart and insulin aspart.